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What is Esophageal Cancer?
The esophagus is a hollow, muscular tube that connects the throat to the stomach. It lies behind the trachea (windpipe) and in front of the spine. Food and liquids that are swallowed travel through the inside of the esophagus (called the lumen) to reach the stomach. In adults, the esophagus is usually between 10 and 13 inches long and is about ¾ of an inch across at its smallest point. The wall of the esophagus has several layers. These layers are important for understanding where cancers in the esophagus tend to start and how they may grow.
Mucosa - this is the layer that lines the inside of the esophagus. The mucosa has 3 parts -
Submucosa - this is a layer of connective tissue just below the mucosa that contains blood vessels and nerves. In some parts of the esophagus, this layer also contains glands that secrete mucus.
Muscularis propria - this is a thick band of muscle under the submucosa. This layer of muscle contracts in a coordinated, rhythmic way to push food along the esophagus from the throat to the stomach.
Adventitia - this is the outermost layer of the esophagus, which is formed by connective tissue.
The upper part of the esophagus has a special area of muscle at its beginning that relaxes to open the esophagus when it senses food or liquid coming toward it. This muscle is called the upper esophageal sphincter.
The lower part of the esophagus that connects to the stomach is called the gastroesophageal (GE) junction. A special area of muscle near the GE junction, called the lower esophageal sphincter, controls the movement of food from the esophagus into the stomach and it keeps the stomach’s acid and digestive enzymes out of the esophagus.
Cancer of the esophagus (also referred to as esophageal cancer) starts in the inner layer (the mucosa) and grows outward (through the submucosa and the muscle layer). Since 2 types of cells can line the esophagus, there are 2 main types of esophageal cancer -
The esophagus is normally lined with squamous cells. The cancer starting in these cells is called squamous cell carcinoma. This type of cancer can occur anywhere along the esophagus.
Cancers that start in gland cells are called adenocarcinomas. This type of cell is not normally part of the inner lining of the esophagus. Before an adenocarcinoma can develop, gland cells must replace an area of squamous cells, which is what happens in Barrett’s esophagus. This occurs mainly in the lower esophagus, which is the site of most adenocarcinomas.
Cancers that start at the area where the esophagus joins the stomach (the GE junction), which includes about the first 2 inches of the stomach (called the cardia), tend to behave like esophagus cancers (and are treated like them, as well), so they are grouped with esophagus cancers.
You may not be able to control every situation and its outcome, but you can control your attitude and how you deal with it.
GOD didn’t add another day in your life because you needed it, he added it because someone out there needs you.
The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen.
Dear GOD, if today I lose my hope please remind me that your plans are better than my Dream.....
Causes of Esophageal Cancer
There are known causes of esophageal cancer that happens when the cells in esophagus develop errors in their DNA. These cells grow and divide abnormally due to these errors. These abnormal cells eventually form a tumor in the esophagus that spreads to surrounding structures including different body parts.
Symptoms of Esophageal Cancer
There are a number of factors which increase a person’s risk of developing esophageal cancer. They include -
Stages of Esophageal Cancer
Stage 0 - in this stage, the abnormal or unusual cells can only be seen in the layer of cells lining the esophagus.
Stage 1 - the first stage is marked by the presence of cancer cells in the layer of cells lining the esophagus.
Stage 2 - in the second stage, the cancer has reached to the outer wall of the esophagus or to the muscle layer of the esophagus. Also these cancer cells may have invaded 1-2 surrounding lymph nodes.
Stage 3 - the third stage is marked by the spread of the cancer into the connective tissue wall or deep into the inner muscle layer. Also this cancer has spread to more lymph nodes close to esophagus and they may also spread beyond esophagus in the surrounding organ.
Stage 4 - this is considered as the advanced stage of esophageal cancer. Now the cancer has spread to lymph nodes far away from the esophagus or to different organs.
Diagnosis of Esophageal Cancer
The medical history and symptoms of a patient are examined for diagnosing esophageal cancer. Some of these tests include -
Other tests, including computed tomography (CT) scans, positron emission tomography (PET) scan, thoracoscopy, and laparaoscopy, may be performed to determine if the cancer has spread, or metastasized, outside of the esophagus. This process is called "staging." The doctor needs this information in order to plan your treatment.
Treatment of Esophageal Cancer
There are a number of treatment options available for esophageal cancer that depends on some factors such as general health of patient, stage of the cancer and the specific site of the primary tumor in the esophagus. Following are some of the treatment options –
Radiotherapy - high-energy radiation beams are targeted on the cancerous tissue in order to destroy it. Radiotherapy is usually used in addition with either chemotherapy or surgery. Radiotherapy can be categorized into two different types for treating esophageal cancer that include -
Surgery - the surgical procedure for removing the entire or a part of the esophagus depends on the location and size of the tumor. There are a number of surgical procedures for reaching to the esophagus. The surgical procedure can remove nearby soft tissues, a section of the esophagus and the lymph nodes. The entire or a part of the stomach can also be removed. The cancer is removed by making several incisions in the abdomen and chest. In majority of cases, the stomach is pulled up and is then joined with the remaining portion of the esophagus. Also, a part of the intestine is used for connecting the stomach with the esophagus remaining part. A part of large intestine or small intestine may also be used. A part of the intestine is used when the stomach is removed for joining it with the left over part of the esophagus to the small intestine.
Chemotherapy - people with esophageal cancer can also be treated with the help of chemotherapy. This therapy makes use of certain drugs that helps in destroying the cancer cells. The injection of these drugs is done into a vein (intravenous) that then travels throughout the different parts of the body.
"Happiness is not something ready made. It comes from your own actions".
"The purpose of our lives is to be happy" - Dalai Lama